Rodell E Cruise Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0054076 Issued in MD

Practice address

2009 Tidewater Colony Dr
Suite 1a
Annapolis, MD 21401-2107

Phone

(410) 224-0010

Fax

(410) 224-0012

NPI assigned

Aug 26, 2005

Reactivated

Mar 20, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Virginia Commonwealth University, School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bon Secours Medical Group Richmond Primary Care LLCGroup PAC ID 3476986613, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bon Secours Southern Virginia Medical Center Hospital, Emporia, VA, CCN 490097

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rodell.cruise.1@14940.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bon Secours Medical Group Richmond Primary Care LLC

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1861050635
  Medicare reassignment Care Compare group NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Carilion Healthcare Corporation

  dba Bridgewater College Student Health Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1447206370
  NPD (past)
• Commonwealth Counseling Associates Inc

  dba LifeStance Health

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bon Secours Mercy Health Emporia LLC

  dba Bon Secours Southern Virginia Medical Center

  • General Acute Care Hospital
  • Emporia, VA
  • NPI 1104461276
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1881687762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 TIDEWATER COLONY DR",
            "address_2": "SUITE 1A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012107",
            "telephone_number": "410-224-0010",
            "fax_number": "410-224-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 TIDEWATER COLONY DR",
            "address_2": "SUITE 1A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012107",
            "telephone_number": "410-224-0010",
            "fax_number": "410-224-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUISE",
        "first_name": "RODELL",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2025-03-20",
        "deactivation_date": "2025-03-06",
        "reactivation_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0054076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005622093",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080180343",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharine Maury Crook, LMSW
• Zadock Oliver Cropper
• Christopher David Crowder, SPTA
• Robert L Crowder, PA
• Christy L. Crowther-Radulewicz, CRNP
• Lori Crum-Sweely
• Cso Voice Annapolis LLC
• Amber Marie Cubbage, NP
• Jennifer Ann Cudzilo, MSPT
• Jeremy Wayne Cugle, MPT

• Family Medicine Physician in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.